Provider Demographics
NPI:1881785269
Name:RAHEMI, EMILY LYNN (PTA)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:LYNN
Last Name:RAHEMI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:LYNN
Other - Last Name:MCCANSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1915 BRIDGEPOINTE CIR
Mailing Address - Street 2:#40
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-6848
Mailing Address - Country:US
Mailing Address - Phone:269-501-7034
Mailing Address - Fax:
Practice Address - Street 1:1006 33RD ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6910
Practice Address - Country:US
Practice Address - Phone:772-567-4804
Practice Address - Fax:772-567-4866
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA20534225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant